several goes of really horrid infected nappy rash - suggestions?

[littlefrog]

I think we're just about getting on top of the latest go of what nappy rash has turned into, but I need to change something in our washing/cleaning regime so that it doesn't get so bad again.
DS, like DH, seems to have v sensitive skin, and the trouble is that when it gets sore, it doesn't get better as quickly as it should. He's had a few goes of nappy rash with big weeping open sores, and is just (I hope) coming to the end of the second time when he's had things that look a bit like boils on the edge of his testicles and his willy. I've been given antibiotic cream for it, which seems to be working a bit, but it's very slow to heal.
What can I do to try and stop it getting so out of control again?
And given that he's had it twice now in the same little place on the end of his willy, should I get the dr to look at it? Should I be cleaning it somehow?
Currently we:

• wash at 40 in Clearspring/sometimes Ecover
• line dry
• use washable wipes with water only
• give LOTS of nappy off time, several hours a day, lately
• don't usually use any kind of barrier cream, occasionally the Weleda calendula one, or lately vaseline

This may not fit with your ethics but if he has weeping sores, you can get a polymer spray called Cavilon from the GP. It basically covers the sores with a plastic layer that breathes but doesn't allow moisture to break through. We foundit invaluable when DS2 had similar awful nappy rash. CAvilon is used for bedsores mostly.

It might help heal it up quickly and then you can work better on what is causing the problem...?

If he has sensitive skin though... Well, it's an option.

Yes get Doc to look at it as it may be thrush, looks different on babies than it does on us ie, red and infected looking. Is very easily treated with canesten etc.

I found Metanium to work wonders - you can buy it from the chemist , also use sudocream as a barrier all the time .

I fidn that Metanium is the only cream that gets rid of my dd's nappy rash. It's so bad sometimes, she actually bleeding (poor love ), but the Metanium often clears it up overnight.

Thanks v much. I don't think this is nappy rash any more, it seems to have gone beyond that (in the sense that the red bits are all much better from all the nappy off time, and the deep sores are only gradually starting to heal with the antibiotic cream etc.)
Dr, useless useless one, did have a quick look on Monday and said use the fucidin cream we already had, but she was so hopeless I don't trust her.

What I really need is advice on prevention... I'm a bit troubled by the idea of using anything medicated (well, anything, really) all the time, but will do so if it's the best option.

It is awful, isn't it, the bleeding sores... I feel like such a terrible mother...

REally, try the Cavilon. We went through everything: starting with sudocrem, tne metanium, then steroids, thrush treatment etc but when it is open sores, they need to be able to heal and when they're constantly getting wet and acidic there's no chance without a proper barrier...

Don't have any suggestions to deal with LO's current sore bum, but once it's on the mend I've found Sudocrem with tonnes of vaseline on top a really good combination. Hope he's better soon.

Conotrane cream is very good, for healing as well as prevention. Obv you need to sort the current bout out first.

Aw, poor DS. Take heart you are not a bad parent, with both of mine it was a particularly bad bout of teething nappies that started the path to bleeding sores.

DS also used to get terrible nappy rash. We finally found a natural cream that worked for us for both day-to-day prevention and treatment when it got bad:
www.yourhealthfoodstore.co.uk/details.php/p2906_jason_earth_s_best_organic_nappy_relief_oint ment.html
It seemed to help with healing.

We had the same trouble with our eldest son and had to resort to antibiotic gel a couple of times to get rid of the bleeding ulcers. You REALLY, REALLY ought to be using some sort of barrier cream - it really is better to use that all the time than have to resort to antibiotics on your child.

In the end, I found Morhulin worked quite well for us (sudocrem and vaseline were no help at all - they seemed to have washed off the minute he weed), provided it was put on quite thickly. It smells a bit of cod liver oil, though, because that's one of the things in it! It wasn't perfect, though - he still got a very sore bottom quite often (he was a frequent pooer, which was the cause of the problems - particularly if he'd eaten a lot of acidic fruit that day...) and wasn't cured of this until he was potty trained. I wish we'd known about Cavilon for the times when his nappy rash got really bad.

the reason i've been anti the idea of barrier cream all the time is because DH has such hopeless skin (lots of things irritate it), and i'd read somewhere here about metanium and stuff sometimes causing more problems than they solve. It's not a religion, if you see what I mean, just a desire not to create new problems through treatment.
Will ask the gp about cavilon, I think it could be really useful (have to say it's all looking a LOT better today, and I'm hoping that my having 4 days at home now will mean I can really get on top of it).
What is morhulin?And conotrane? where would I get them?

Please please get them to swab the sores . My dd is now 5 and has scars on her vulva where she had dreadful nappy rash triggered by hideous teething poos that got infected. They told us to treat with fucidin and this made it worse as it was a bacterial infection . She actually had some rare pseudomonas ??? bacterial infection that only one strain of absolutely gopping anti-biotics could clear up. It was awful. It still makes me feel sad.
I used cloth nappies (dd2 had no problems like this) but I am afraid I would recommend a disposable until the sores have healed. The disposables just help to keep the area dry, particularly important over night.
Also recommend Metanium which sorted any further problems we had following this trauma. And a barrier cream is a good idea if he is that sensitive .
I am sad for you. It broke my heart to see my dd like that.

Metanium is like glue. You won't have to use it often or for long but unlike some other creams it will stick to the sore area. It is drying but this was a small side effect for us to deal with over the hideous teething poo induced nappy rashes.
Weleda nappy cream is a nice one for more regular use.

You need to get swabs done, dd has been treated for neary 12 months for thrush (sometime with AB because the spots looked infected etc) turns out it was something else altogether - some bacteria from her gut living on her skin & she has UTI. I am furious that we've been fobbed off for so long, I potty trained her early as I was told that would sort the issue out etc.

Another very good spray for nappy rash, again designed for bed sores is Sprilon worked on all 2 of mine when all else (inc metanium had failed)

In terms of prevention use disposables at night? My dds kept get horrifc excema etc until we resorted to one disposable overnight and cloth the rest of the time and that made a huge difference.

Get swabs done for sure. A normal nappy rash if been treated should not last for longer than 24 hours so it sounds like he may have an infection.

Clean area with water and cotton. Use olive oil for a prevention/treatment of nappy rash. It is super easy and works well - I use it on baby after each nappy change. If they do have a nappy rash at night times I put olive oil and then a layer of vasilene.

Also may be worth trying disposable as they do keep skin dryer for longer.

Gosh. That is very helpful, and I will go to the gp with him on monday (why didn't I post yesterday evening ) and get swabs done. Depressing reading, especially from vanillapumpkin, your poor dd, but you have put your finger on exactly what I'm worried about. He's had these horrid sores in the same place right on the end of his willy, and I'm scared that it might, conceivably, end up causing him problems or pain or whatever down the line. I've taken him before, and they gave him nystatoform/nystatin (can't remember the exact name) first time, which healed things nicely. Then he just had this horrid willy sore some months later, and they gave us fucidin for that (which did clear it up, I thought, but took ages to do so). And now we've had a double bash.
I'll go and buy some more disposables tomorrow and give him a few days in those too, though I'm not sure that'll help much - he wears disposables at the CM 2 days a week, then yesterday was nappy free for probably 3-4 hours, and again for probably 2-3 hours today...
Should I wash the nappies super-hot for a while, do you think? Could he be getting reinfected off the nappies themselves?
I would have done something more active about this before, but (extraordinarily) he doesn't seem to be in pain from it, and our surgery has been in such a mess lately that I've been avoiding going...

blasting the nappies at 60 wouldn't do any harm but it's quite likely that the swabs will show something up ask for a urine sample to be taken too.

I am pretty sure Nystatin is for Thrush. If it is that then washing nappies hot is a good idea though I beleive 60 degrees kills bacteria.....
DON'T feel bad. You have done exactly what I did, taken them to the doctor and followed their advice. Sadly for me it was duff advice and I was told to return if things hadn't improved after 7 days. I was too desperate not to be one of those fussing Mums but after three days I felt it was worse and so took her back and indeed it was . They said the bacteria lived in her gut and was nothing to do with anything I did or didn't do etc but I still felt crap and cried, lots...
She certainly suffered again (her teething poos were something to behold. They seemed to burn on contact ) but I insisted they took swabs every time, before we got to the open sores stage.
Wash with water, perhaps with a little camomile tea in as that is soothing.
He will be fine. I don't think it is as bad as dd1's was.
And willies are full of odd wrinkles and folds, he won't notice a thing when he is older .

Nystatin and Fucidin are different treatments. They should always swab imo. I am sure that the hydrocortisone in the Fucidin made the infection worse and helped to lead to the scars she has. I just hope she will not be into the Hollywood when she is older . And I am sure her scars will have faded and look better then. I hope....

hell im going to say it - can you switch to pampers when out and about - they wick any liquid away from his poor bits. When its all cleared up you can go back to the washables. Sorry - I'm not a big fan of disposables either - I used eco ones but when nappy rash gets that bad I think that is the kindest way. Can you imagine it on your bits?

Hi, Littlefrog,

It does seem as though they are guessing what is causing your son's problems - and if Nystatin worked quickly last time, but Fucidin is only working very slowly this time, then it is possible that it is another mainly fungal infection (ie thrush) for which Nystatin would work, rather than Fucidin, which is used to treat some common bacterial infections. So I would suggest going back to your GP and maybe insisting on a swab as other posters have suggested.

I agree, the nappies should be washed on a hotter cycle at the moment, to be on the safe side, and probably also would use disposables at least overnight until it's cleared up.

You can buy Morhulin (or order it) in Boots - but they keep it in a drawer behind the counter rather than on the shelves. Its active ingredients are Zinc Oxide and Cod Liver Oil. It does also contain liquid paraffin, yellow soft paraffin, "lanolin anhydrous BP" (not sure if this could be a problem - lanolin can cause allergies in some people, but don't know if lanolin anhydrous is the same thing, since very pure lanolin, as per the Lansinoh nipple cream, isn't supposed to be a problem in sensitive people, so maybe it's OK.... waffle, waffle... anyway, my children have never had any reactions to it), and diluted sodium hypochlorite solution.

I hope it clears up soon - I know how horrid and frustrating it is. Very lucky it doesn't seem to hurt your son, though - mine used to wail when I tried to clean his bottom with all those sores on it.

on a bit of a different note does your ds drink alot of juice as stopping ds from having even well diluted juice made a big difference whne he had bad nappy rash caused initially by teething

oh oh i hadn't realised that fucidin was a steroid cream, this is awful! The pharmacist told me with the Nystaform that we should only use a tiny tiny amount, as it contained hydrocortisone. She didn't say that for the fucidin and, thinking it was an antibiotic cream, I didn't look at the ingredients DH has in the past had problems as a result of using steroid creams for more than a day or so on his eczema.
Right, I am going to go and buy some disposables as soon as DH wakes up (his turn for a lie-in), and DS can be nappy free till then.
Oh I do feel bad, why didn't I take him yesterday morning? I should have thought of the swab thing...

have you tried teeting powders for him it will make his wee less acidic which may help until you get this properly sorted.

Teething powders? Do you mean that homeopathic granule stuff?